{include "header.tpl"}

<link href="/css/bootstrap-switch.min.css" rel="stylesheet" media="screen">
<script src="/js/bootstrap-switch.min.js"></script>
<link rel="stylesheet" href="/css/skins/square/blue.css"/>
<script src="/js/icheck.min.js"></script>

<form id="domainForm" rel="ajax" method="post" action="/Order/orderModify" enctype="multipart/form-data" class="form-horizontal" role="form" onsubmit="domainSubmit()">

    <div class="form-group form-group-sm">
        <label for="" class="col-sm-3 control-label">连锁店:</label>
        <div class="col-sm-5">
            <select name="shop_id" class="form-control" >
                <option value="">--请选择连锁店--</option>
                {foreach $chainData as $key => $value}
                    <option value="{$value['id']}" {if $data.shop_id eq $value['id']}selected="selected"{/if}>{$value['name']}</option>
                {/foreach}
            </select>
        </div>
    </div>




    <div class="form-group form-group-sm">
        <label for="" class="col-sm-3 control-label">收货人:</label>
        <div class="col-sm-5">
            <input type="text" name="contact" value="{$data.contact}" class="form-control" required/>
        </div>
    </div>

    <div class="form-group form-group-sm">
        <label for="" class="col-sm-3 control-label">收货人手机号:</label>
        <div class="col-sm-5">
            <input type="text" name="phone" value="{$data.phone}" class="form-control" required/>
        </div>
    </div>

    <div class="form-group form-group-sm">
        <label for="" class="col-sm-3 control-label">详细地址:</label>
        <div class="col-sm-5">
            <input type="text"  name="address" value="{$data.address}" class="form-control" required/>
        </div>
    </div>

    <div class="form-group form-group-sm">
        <label for="" class="col-sm-3 control-label">备注:</label>
        <div class="col-sm-5">
            <input type="text" name="remark" value="{$data.remark}" class="form-control" />
        </div>
    </div>
    <div class="form-group form-group-sm">
        <label for="" class="col-sm-3 control-label">状态:</label>
        <div class="col-sm-5">
            <select name="status" class="form-control" required>
                <option value="">--请选择订单状态--</option>
                {foreach $userStatus as $key => $value}
                    <option value="{$key}" {if $data.status eq $key}selected="selected"{/if}>{$value}</option>
                {/foreach}
            </select>
        </div>
    </div>

    <div class="form-group form-group-sm">
        <label for="" class="col-sm-3 control-label">&nbsp;</label>
        <div class="col-sm-3">
            <input type="hidden" name="id" value="{$smarty.get.id}"/>
            <button type="submit" class="btn btn-primary">提交</button>
        </div>
    </div>
</form>

<script type="text/javascript">


</script>
{include "footer.tpl"}